At the end of an otherwise uncomplicated pars plana vitrectomy, routine indirect ophthalmoscopy reveals a previously absent iatrogenic retinal tear. At which location are iatrogenic breaks during PPV most frequently encountered?

• A Randomly distributed, with no predilection for any quadrant
• B Centrally at the posterior pole during membrane peeling
• C At the equator diametrically opposite the infusion cannula
• D At or adjacent to the sclerotomy entry sites ✓

Explanation

Most iatrogenic breaks occur at or near the sclerotomy ports, created when peripheral vitreous base is inadvertently engaged by the cutter or pulled by instrument passage through the wound. For this reason, careful shaving of the vitreous base around the entries and a deliberate search of all three sclerotomies with indentation at the end of surgery are mandatory. Posterior pole breaks from membrane peeling do occur but are far less common.

Reference: Ryan's Retina, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.